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Fitz 9th > 79 - Rosacea > Flashcards

79 - Rosacea Flashcards

1
Q

Rosacea affects (men/women) more than (men/women) (3:1)

A

Women

Men

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2
Q

Hallmark of rosacea

A

Flushing

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3
Q

Characteristic of male patients with rosacea

A

Rhinophyma

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4
Q

Persistent erythema is defined as erythema that lasts for at least

A

3 months

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5
Q

Phymatous rosacea of the nose

A

Rhinophyma

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6
Q

Phymatous rosacea of the chin

A

Gnathophyma

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7
Q

Phymatous rosacea of the forehead

A

Metophyma

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8
Q

Phymatous rosacea of the eyelids

A

Blepharophyma

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9
Q

Phymatous rosacea of the lower half of the helices of the ears and the lobes

A

Otophyma

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10
Q

Compression of rhinophyma produces a white pasty matter that is composed of

A

Sebum
Corneocytes
Bacteria
Sometimes Demodex folliculorum mites

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11
Q

Y/N: The incidence of both basal and squamous cell carcinomas has been reported to be higher in rhinophyma-affected skin than in nonlesional skin

A

Yes

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12
Q

Rhinophymata are particularly frequent when associated with

A

Seborrhea

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13
Q

Flushing in rosacea is a pathophysiological neurovascular process in the central face experienced for more than

A

5 to 10 minutes

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14
Q

Both genders are equally susceptible to flushing without age preference, although in women, it is more frequent during

A

Menopause

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15
Q

_____ is, with erythema, the most common complaint in patients with rosacea

A

Prolonged and frequent flushing

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16
Q

Rosacea flushing can often be linked to typical trigger factors, mostly

A 
Heat
Hot steam
Red wine and certain alcoholic beverages
Medications such as niacin or topical glucocorticoids
Noxious cold
Hormonal changes (menopause)
Rarely systemic disease
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17
Q

_____, in contrast to flushing, is almost exclusively induced by emotionally stressful situations and not by spicy food or other rosacea trigger factors

A

Blushing

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18
Q

“Pale islands” in between the salmon-like redness are characteristic of

A

Blushing

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19
Q

Permanent dilated blood vessel on the skin or mucosal surface

A

Telangiectasia

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20
Q

Forehead rosacea almost exclusively develops in patients with

A

Male pattern baldness

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21
Q

Y/N: Ocular rosacea involves the eyelids, eyelashes, or eyes of patients with rosacea, and if left untreated, bears risk of blindness

A

Yes

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22
Q

Distinct subform of rosacea defined by chronic, therapy-resistant, 0.2- to 0.3-cm-sized, often follicular brown-red or red papules that can develop to epithelioid (_____), granulomatous plaques and nodules on the cheek, forehead, or chin

A

Lupoid or granulomatous rosacea

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23
Q

Rare, chronic, and severe form of rosacea

Hemorrhagic nodular abscesses and indurated plaques on erythematous background

A

Rosacea conglobate

24
Q

Rare, acute or subacute, developing, maximal variant of rosacea with acne conglobate-like progression and predilection for postadolescent (20-30 years) women, particularly pregnant women

A

Rosacea fulminans (Pyoderma faciale-o’Leary)

25
Q

Ingestion of _____ might cause rosacea-like reaction or deteriorate a persisting rosacea

A

Iodides

Bromides

26
Q

Potential sources of halogen exposure

A 
Citrus-flavored softdrinks (cola drinks)
(Sea)food
Diagnostic radiocontrast media
Pool disinfectants
Certain topical antiseptics
Permanent hair wave formulations
Vitamin preparations
Medications (eg, thyroid medication, chemotherapeutics)
27
Q

Halogen rosacea typically improves in _____ after elimination of exposure

A

4 to 6 weeks

28
Q

When a patient with rosacea is treated with topical corticosteroids for a prolonged time, the atrophic side effects of the medication sometimes lead to an aggravation of the condition

A

Steroid rosacea

29
Q

Characteristic clinical finding is the development of miniscule yellow pustules on a preexisting or newly formed erythema background

A

Gram-negative rosacea

30
Q

Diffuse idiopathic solid upper-facial edema

A

Morbihan disease or

Edematous rosacea

31
Q

In (rosacea/Morbihan disease), edema is present as hard, nonpitting swellings of mainly the caudal half of the face but also the glabella

A

Rosacea

32
Q

Demodex mites are particularly found in association with _____ lesions

A

Papulopustular

33
Q

Commensal of human and animal skin, predominantly in oily skin close to the pilosebaceous glands, and is increased in some patients with rosacea, predominantly in those with phymata as well as papules and pustules

A

Demodex folliculorum

34
Q

Patients with rosacea, suffer from _____, as well as _____, both markers for skin barrier dysfunction

A

Increased transepidermal water loss

pH increase of the facial skin

35
Q

Histological analysis and transcriptome studies reveal the presence of predominantly _____ and to lower extend _____ T cells and cytokines in rosacea skin

A

CD4+

CD8+

36
Q

The human face is to a certain extent physiologically unique because it is one of the few regions in the human skin where the blood vessels are under control of the

A

Sympathetic
Parasympathetic
Sensory nerves

37
Q

Y/N: The skin shows normal vascular responses to application of epinephrine, norepinephrine, and acetylcholine in patients with rosacea

A

Yes

38
Q

Perivascular inflammatory infiltrate consisting mainly of Th1 and Th17 cells, as well as macrophages and mast cells
Blood and lymphatic vessels are markedly dilated
Dermal edema

A

Erythematous skin and telangiectasia

39
Q

CD4+ Th1 and Th17 cells, macrophages, mast cells, and plasma cells

A

Papules

40
Q

CD4+ Th1 and Th17 cells, macrophages, mast cells, and plasma cells
Additional neutrophils can be found

A

Pustules

41
Q

Th1 and Th17 cells, macrophages, mast cells, and more plasma cells
Glandular hyperplasia and follicular plugging without comedones can be found as well as fibrosis and increase in fibroblasts

A

Phymatous rosacea

42
Q

Dermal edema and vasodilation as well as dermal granulomas of the tuberculoid type with T cells and macrophages as well as mutinucleated giant cells and plasma cells

A

Granulomatous rosacea

43
Q

Differentiates rosaces from other granulomatous disorders such as lupus vulgaris

A

Marked upper dermal vasodilation of blood and lymphatic vessels

44
Q

Most consistent histopathologic abnormality

A

Change in the collagen of the upper dermis, so-called “solar elastosis”

45
Q

Four distinct clinical subtypes of rosacea

A
  1. Erythematotelangiectatic
  2. Papulopustular
  3. Phymatous
  4. Ocular rosacea
46
Q

Diagnostic features of rosacea

A
  1. Persistent centrofacial erythema associated with periodic intensification by potential trigger factors
  2. Phymatous changes
47
Q

Major features of rosacea

A
  1. Flushing or transient erythema
  2. Inflammatory papules and pusutles
  3. Telangiectasia
  4. Ocular manifestations
48
Q

Secondary features of rosacea

A
  1. Burning sensation of the skin
  2. Stinging sensation of the skin
  3. Edema
  4. Dry sensation of the skin
49
Q

For persistent erythema, approved therapeutic regimens are

A 
Topical brimonidine gel (1%)
Oxymetazolene cream (1%)
50
Q

Off-label therapy for persistent erythema

A

Beta-blockers such as carvedilol

51
Q

Common treatment used for flushing and transient erythema

A

Laser therapy

52
Q

Off-label therapy for flushing and transient erythema

A

Topical adrenergic receptor modulators (eg, brimonidine, oxymetazoline)

53
Q

Telangiactasia can only be treated with

A

Laser therapy

0.5% to 1.0% aethoxysclerol injections

54
Q

Mild to moderate papules and pustules respond well to topical therapy such as

A 
Ivermectin (1%)
Metronidazole (0.75%-1%)
Azelaic acid (15%)
Sodium sulfacetamide
Sulphur
55
Q

Off-label therapy for papules and pustules

A

Oxytetracyclin 500 mg twice a day
Doxycycline 100 mg twice a day
Minocycline 50 mg/day
Erythromycin 500 mg twice a day

56
Q

There is substantial evidence that _____ has a beneficial effect in early as well as established rosacea because of its inhibitory effects on sebaceous glands as well as some antiinflammatory capacity
Can also be used before laser and dermatosurgery procedures to reduce size and inflammation

A

Low-dose isotretinoin

Fitz 9th (108 decks)

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